title: Cerebral air embolism via port catheter and endoscopic retrograde cholangio-pancreatography.
abstract: BACKGROUND
  Cerebral air embolism (CAE) is a critical clinical condition necessitating rapid diagnosis and therapeutic measures.
  
  
  METHODS
  The authors describe two patients with lethal CAE.
  
  
  RESULTS
  An 81-year-old man rapidly developed coma with tetraplegia. CT-scan revealed prominent CAE whereby the entry of the air was via a port catheter for parenteral nutrition. A 45-year-old man with severe alcohol-toxic multiple organ damage needed endoscopic retrograde cholangio-pancreatography (ERCP) and a second esophagogastroscopy. After an epileptic seizure, the CT-scan of the brain showed small amounts of cerebral air in the posterior right hemisphere and in the sagittal superior sinus. Despite critical care the patient died.
  
  
  CONCLUSIONS
  CAE is a neurocritical emergency case. Early CT-scan of the brain can detect air, guide further therapy, and contribute to the assessment of the prognosis.
authors.affiliation: Department of Neurology, Municipal Hospital Landshut, Robert-Koch Str. 1, 84034 Landshut, Germany.
authors.forename: Ivana
authors.initials: I
authors.lastname: Vachalová
authors.forename: Stefan
authors.initials: S
authors.lastname: Ernst
authors.forename: Irina
authors.initials: I
authors.lastname: Vynogradova
authors.forename: Silke
authors.initials: S
authors.lastname: Wöhrmann
authors.forename: Josef G
authors.initials: JG
authors.lastname: Heckmann
keywords: Cerebral air embolism; Cranial computed tomography; Endoscopic retrograde cholangio-pancreatography; Esophagogastroduodenoscopy; Port catheter